Pre-operative experiences and post-operative benefits of ptosis surgery: A qualitative study

© 2017 Taylor & Francis. This qualitative study sought to explore the experiences of patients who had undergone successful ptosis correction surgery. Participants were recruited from Bristol Eye Hospital. Nine participants were interviewed using a semi-structured interview schedule and open ended questions. Data were analysed using inductive thematic analysis. Four major themes were identified from patient accounts. Patients described the psychosocial and functional difficulties they experienced living with ptosis, and the subsequent benefits of surgery. Patients reported experiencing appearance related anxiety pre-operatively due to their condition and engaging in behaviours to avoid social encounters. Gender differences were noted in the internalization of perceived negative reactions from others, with men describing fewer adverse impacts. Patients described perceived barriers to seeking surgery including a lack of awareness of ptosis as a treatable condition, the perception that being concerned with their appearance could be seen as vain and the view that ptosis surgery is synonymous with cosmetic surgery. Following successful surgery patients outlined positive impacts on their vision, appearance and psychosocial well-being after successful surgery. This qualitative study highlights the complexities of the factors and processes contributing to the psychosocial impacts of ptosis and the potential benefits of surgery and/or psychosocial support. An increased awareness amongst people with ptosis of the potential positive impacts of surgery and an enhanced understanding of the reasons why patients may not seek treatment amongst health care professionals are likely to benefit this often overlooked patient group

What difference does it make? Women’s pop cultural production and consumption in Manchester.

This paper explores the experiences of women in small cultural businesses and is based upon interviews with women working in a range of contexts in Manchester's popular music sector. The research seeks to promote wider consideration of women's roles in cultural production and consumption. We argue that it is necessary that experiences of production and consumption be understood as inter-related processes. Each part of this process is imbued with particular gender characteristics that can serve to reinforce existing patterns and hierarchies. We explore the ways in which female leisure and consumption patterns have been marginalised and how this in turn shapes cultural production. This process influences career choices but it is also reinforced through the integration of consumption into the cultural workplace. Practices often associated with the sector, such as the blurring of work and leisure and 'networking', appear to be understood and operated in significantly different ways by women. As cultural industries such as popular music are predicated upon the colonisation of urban space we explore the use of the city and the particular character of Manchester's music scene. We conclude that, despite the existence of highly contingent and individualised identities, significant gender power relations remain evident. These are particularly clear in discussion of the performative and sexualised aspects of the job

Strengthening health information systems for disability-related rehabilitation in LMICs

The purpose of this study was to describe the state of rehabilitation health information systems (HIS) in different settings, and identify key processes and actions which contribute to the development of HIS which can effectively support low- and middle-income countries (LMICs) allocate resources to health-related rehabilitation to people with disabilities. Nine case studies were conducted across different disability and developmental settings using documentary review and semi-structured key informant interviews (N = 41). Results were analysed against the six building blocks of a HIS, based on the Health Metrics Network Framework and Standards for Country Health Information Systems and existing HIS capacity. Key barriers or enablers to good disability data collection and use, were documented for each HIS component. Research results suggest there is no gold standard HIS for rehabilitation. There was broad consensus however, that effective health related disability planning requires reliable data on disability prevalence, functional status, access to rehabilitation services and functional outcomes of rehabilitation. For low-resource settings, and where routine HIS are already challenged, planning to include disability and rehabilitation foci starting with a minimum dataset on functioning, and progressively improving the system for increased utility and harmonization, is likely to be most effective and minimize the potential for overburdening fragile systems. The recommendations from this study are based on the successes and challenges of countries with established information systems, and will assist LMICs to prioritize strategic measures to strengthen the collection and use of data for rehabilitation, and progressively realize the rights of people with disabilities

Age Strengthening of Gray Cast Iron Phase III

The primary objective of this research is to identify the age strengthening mechanism in gray and ductile cast iron, and to quantify the parameters that control it. It is also to contribute to a new predictive model for gray and ductile iron strength and hardness. This work shows that age strengthening occurs on a sigmoidal-logarithmic scale in gray and ductile cast irons, to a statistically significant extent. This is similar to Avrami-Johnson-Mehl kinetics for phase transformations in metals. It occurs in both cupola-melted iron and induction melted iron. However, it does not happen in all compositions. We have developed some understanding of the process. Data suggests that nitrogen and nitride-forming trace elements have a significant role in the process, but that is yet not fully characterized. Also, the time dependence of the bulk hardness and strength increase, the nano-scale precipitation evidence from neutron scattering, differential scanning calorimetry results and matrix micro-hardness increase in ferrite all indicate that age strengthening occurs by a precipitation or pre-precipitate cluster formation mechanism

Epidermal grafting versus split-thickness skin grafting for wound healing (EPIGRAAFT): study protocol for a randomised controlled trial

BACKGROUND: Split-thickness skin grafting (SSG) is an important modality for wound closure. However, the donor site becomes a second, often painful wound, which may take more time to heal than the graft site itself and holds the risk of infection and scarring. Epidermal grafting (EG) is an alternative method of autologous skin grafting that harvests only the epidermal layer of the skin by applying continuous negative pressure on the normal skin to raise blisters. This procedure has minimal donor site morbidity and is relatively pain-free, allowing autologous skin grafting in an outpatient setting. We plan to compare EG to SSG and to further investigate the cellular mechanism by which each technique achieves wound healing. METHODS/DESIGN: EPIGRAAFT is a multicentre, randomised, controlled trial that compares the efficacy and wound-healing mechanism of EG with SSG for wound healing. The primary outcome measures are the proportion of wounds healed in 6 weeks and the donor site healing time. The secondary outcome measures include the mean time for complete wound healing, pain score, patient satisfaction, health care utilisation, cost analysis, and incidence of adverse events. DISCUSSION: This study is expected to define the efficacy of EG and promote further understanding of the mechanism of wound healing by EG compared to SSG. The results of this study can be used to inform the current best practise for wound care. TRIAL REGISTRATION: Clinicaltrials.gov identifier, NCT02535481 . Registered on 11 August 2015

Geogenic lead isotope signatures from meat products in Great Britain: potential for use in food authentication and supply chain traceability

This paper presents lead (Pb) isotope data from samples of farm livestock raised in three areas of Britain that have elevated natural Pb levels: Central Wales, the Mendips and the Derbyshire Peak District. This study highlights three important observations; that the Pb found in modern British meat from these three areas is geogenic and shows no clear evidence of modern tetraethyl anthropogenic Pb contribution; that the generally excellent match between the biological samples and the ore field data, particularly for the Mendip and Welsh data, suggests that this technique might be used to provenance biological products to specific ore sites, under favourable conditions; and that modern systems reflect the same process of biosphere averaging that is analogous to cultural focusing in human archaeological studies that is the process of biological averaging leading to an homogenised isotope signature with increasing Pb concentration

Nephritogenic autoantibodies but absence of nephritis in Il-12p35–deficient mice with pristane-induced lupus

Nephritogenic autoantibodies but absence of nephritis in Il-12p35–deficient mice with pristane-induced lupus.BackgroundThere is strong evidence that Th1 cytokines are essential for disease in murine models of lupus. Interleukin-12 (IL-12) is essential for Th1 cell differentiation and induces interferon-γ (IFN-γ) production. Paradoxically, it has been suggested that an IL-12 defect drives the pathogenesis of lupus, although its precise role remains unclear. We investigated the role of IL-12 for lupus-like disease induced by pristane. IL-12p35–deficient (-/-) and control (+/+) BALB/c mice were treated with pristane or phosphate-buffered saline (PBS).MethodsProteinuria was measured and renal pathology evaluated 10 months after treatment. Sera were analyzed for autoantibodies and total immunoglobulin levels. Cytokine expression and production was analyzed.ResultsPristane induced nephritogenic autoantibodies and renal immunoglobulin and complement deposition in both IL-12 -/- and +/+ mice. However, proliferative pathology and proteinuria were absent in IL-12-/- mice, whereas pristane induced severe nephritis in one third of the +/+ mice. As expected, cytokine balance was skewed toward a Th2 response in pristane-treated IL-12 -/- mice.ConclusionThese data indicate that renal immune complex deposition can occur in the absence of IL-12p35, but that structural renal damage requires the presence of IL-12p35 or mediators induced by this molecule, such as IFN-γ. In contrast to the abrogation of nephritogenic autoantibodies by the lack of IFN-γ, such antibodies are induced by pristane in IL-12p35–deficient mice. Absence of structural renal disease, despite the presence of nephritogenic autoantibodies in pristane-treated IL-12-/- mice, indicates that antibody deposition alone is not sufficient for the development of lupus nephritis in this model

Seismic behaviour of geotechnical structures

This paper deals with some fundamental considerations regarding the behaviour of geotechnical structures under seismic loading. First a complete definition of the earthquake disaster risk is provided, followed by the importance of performing site-specific hazard analysis. Then some suggestions are provided in regard to adequate assessment of soil parameters, a crucial point to properly analyze the seismic behaviour of geotechnical structures. The core of the paper is centered on a critical review of the analysis methods available for studying geotechnical structures under seismic loadings. All of the available methods can be classified into three main classes, including the pseudo-static, pseudo-dynamic and dynamic approaches, each of which is reviewed for applicability. A more advanced analysis procedure, suitable for a so-called performance-based design approach, is also described in the paper. Finally, the seismic behaviour of the El Infiernillo Dam was investigated. It was shown that coupled elastoplastic dynamic analyses disclose some of the important features of dam behaviour under seismic loading, confirmed by comparing analytical computation and experimental measurements on the dam body during and after a past earthquake